Methods for sensitive detection of reverse transcriptase

ABSTRACT

The present invention provides a method for detecting the presence of a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA; and c) detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

This application is a continuation, of application Ser. No. 08/379,851, filed Jan. 27, 1995, now abandoned.

BACKGROUND OF THE INVENTION

1 Field of the Invention

The present invention provides a method for detecting the presence of a retrovirus in a biological sample by detecting the presence of the enzyme, reverse transcriptase. The method utilizes a template and primers in conditions under which a DNA strand is synthesized and subsequently amplified by the polymerase chain reaction, if reverse transcriptase is present.

2. Background Art

Retroviruses are widely distributed in vertebrates and are known to cause a variety of diseases in man and animals including immunodeficiencies, leukemias and lymphomas (1). The entire retrovirus family is characterized by the presence of a unique enzyme, reverse transcriptase (RT), which transcribes the viral genomic RNA into a double-stranded DNA copy (1). This feature has led to studies of the unique enzymatic function of RT for two main applications. First, the presence of RT has been the basis for diagnosis of retroviral infection and for the generic detection of the presence of retroviruses in cell cultures and in the infected host. Second, the RT enzyme constitutes a primary target for antiviral drug intervention (1,2).

The polymerase function of RT from several retroviruses has been well characterized and shown to require an RNA template, a primer, triphosphate, a divalent cation and physiological salts (1). Therefore, assays for RT activity have conventionally used these reagents and conditions to measure the ability of a sample to produce a DNA copy of a known exogenous RNA template (e.g., poly rA) by synthesizing a complementary DNA oligonucleotide primer with radiolabeled nucleotides (e.g., ³ H- or ³² P-dTTP). RT synthesized DNA has been detected by measuring incorporation of the labeled nucleotide (3,4) and more recently, by assays which employ nonradioactive nucleotides in enzyme linked immunosorbent assay (ELISA) formats have been developed (5-8) and by polymerase chain reaction (PCR) (17), as further described below.

Although RT assays continue to be an essential laboratory tool for the identification of known and novel retroviruses (4-11), the successful use of RT assays has been limited to the detection of retroviral particles in culture supernatant (4-8), which has the disadvantage of requiring that a virus be cultured before detection. By the present methods, lentiviruses, such as human immunodeficiency virus-1 (HIV-1) may be readily detected, but oncoviruses, such as human T lymphocytic virus types I and II (HTLV-I and HTLV-II), are much more difficult to detect, presumably because of poor RT activity and because they are typically cell-associated, which means their RT is less accessible for detection in culture supernatants (6-8). This limitation has rendered RT testing of little value in the detection of HTLV infection.

Despite multiple attempts to improve the sensitivity of RT assays, the direct detection of retroviruses in clinical samples (e.g., serum) has been unsuccessful (4-12). For example, in studies of HIV-1 infected individuals, detection of virus in plasma by RT assays has been largely abandoned because of the low sensitivity of this method (12).

The inability to detect RT activity in serum hinders the use of this virological marker in diagnosing disease, monitoring drug efficacy in patients, monitoring virus load and predicting disease progression. Present methods for qualitative and quantitative detection of plasma HIV-1 include viral isolation and p24 antigen capture (13-15). However, these assays have disadvantages. Virus isolation from plasma requires virus culture that is typically maintained for 14 to 28 days and is labor intensive, time consuming, fraught with biological variation and is not a universal marker in the infected population given the low levels of HIV-1 in patients with CD4+ T lymphocyte counts of >200/mm³. Similarly, p24 antigen, either free, virion-associated, or immune complexed, is not always present in the HIV-1 infected population.

RT-PCR permits the qualitative detection of the cell-free virus in plasma using an exogenous RT and a primer pair of known sequence to amplify viral RNA sequences in the plasma (15,16). Although RT-PCR has been reported to be highly sensitive, this assay requires RNA extraction and multiple sample manipulations that may increase the risks of PCR contamination. The RT-PCR assay may be complicated further by the lack of a standardized universal quantitative test and the variabilities that may be incurred during processing and storage with regard to the degradation of the genomic RNA. Although RT-PCR, like antigen capture, is highly specific, a knowledge of the nucleotide sequence of the target retrovirus fragment is necessary for primer development. Given this limitation, RT-PCR is not suitable for detecting variant, novel, or unknown retroviruses.

Recently, two assays for RT, which use the RNA of bacteriophage MS2 or brome mosaic virus (BMV) as a template and PCR as a detection system, have been reported to be highly sensitive for the detection of murine leukemia virus RT and other stocks of retroviruses in serum (18,19). However, the evaluation of the specificity and the sensitivity of these assays on adequate numbers of serum specimens was not disclosed (18,19). In addition, in both of these assays, problems with inhibitors of RT activity in serum and nonspecific background RT activity have been described (20), raising serious questions about the diagnostic value of these assays.

HIV-1 is classified by phylogenetic analysis into two groups, group M (major) and group O (outlier). Group M comprises at least nine subtypes that are referred to as A through I, while group O included all divergent viruses that do not cluster with group M strains. Like group M HIV-1 viruses, group O viruses also cause AIDS. The identification of group O viruses raised public health concerns regarding the safety of the blood supply because of initial reports of the inability of the subtype B-based serologic screening assays to consistently detect group O infections (35,46). Type O infections have been identified in the West Central African countries of Cameroon and Gabon with a seroprevalence of 2-7% of all HIV-1 infections in these areas (33,34,37,43,45). However, type O infections may not be geographically limited to West Africa. Spread of type O infections to Europe and more recently to the United States has also been documented (44,47,48). The spread of type O infections beyond West Africa emphasizes the need for improved screening of the international blood supply. Ideally, the improved screening assays should be highly sensitive in detecting all variants of HIV-1 group O and M viruses. Attempts to improve serologic screening are being made by the use of whole HIV-1 virus lysates or by addition of Group O-specific peptides. However, the overall sensitivity of these assays in detecting all variants of group O infections is not fully determined for several reasons. First, the full spectrum of genetic variability in group O viruses is not known and therefore, it is not possible to predict if the present assays will be able to detect all variants of group O infections. Second, the number of well-characterized group O samples that are available for evaluating new assays may not be large enough for an adequate assessment of the performance of these assays (35,46,48). Therefore, the need still exists for a generic screening assay that can differentiate group M infections from group O infections and that is not affected by the degree of divergence within group O.

This invention provides a RT assay that employs a PCR-based amplification system to detect a known cDNA product of the RT reaction. The assay of the present invention, referred to hereafter as Amp-RT, is highly sensitive and specific, requires no knowledge of viral genomic sequence and allows the detection of RT activity in samples of individuals infected with retroviruses or any other biological entity that produces RT. The present invention also fulfills the need for a differentiation assay as described above by providing an assay in which the RT activity of group M viruses is differentiated from that of group O viruses by selective inhibition by the group M-specific RT inhibitor, nevirapine.

SUMMARY OF THE INVENTION

The present invention provides a method for detecting the presence of a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA; and c) detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

The present invention also provides a method of detecting the presence of a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with an RNA template, wherein the RNA template is a suitable region of the encephalomyocarditis virus which consists of the ribonucleotide of SEQ ID NO:4 and a complementary DNA primer, wherein the primer is the oligonucleotide of SEQ ID NO:2, under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA, wherein the amplification is by the polymerase chain reaction method whereby the conditions for the amplification comprise 30-40 cycles of heating the synthesized DNA and a primer pair to 93° to 96° C. for 30 seconds to one minute, 53° to 56° C. for 30 seconds to one minute and 70° to 74° C. for 30 seconds to five minutes, wherein the primer pair consists of the oligonucleotide consisting essentially of SEQ ID NO:1 and the oligonucleotide consisting essentially of SEQ ID NO:2; and c) detecting the amplification of the synthesized DNA, wherein the detection of the amplification of the synthesized DNA is by Southern blot hybridization assay, with a probe consisting essentially of the oligonucleotide of SEQ ID NO:3, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

Additionally provided is a kit for detecting the presence of a retrovirus in a biological sample, comprising a suitable region of the encephalomyocarditis virus genome as an RNA template and a complementary DNA primer for reverse transcriptase and a primer pair for polymerase chain reaction, whereby each component is provided in separate containers or any combination of the components is provided in a single container.

Further provided is a method of detecting the presence of a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with an RNA template, wherein the RNA template is a region of the encephalomyocarditis virus which consists of the ribonucleotide of SEQ ID NO:4 and a complementary DNA primer, wherein the primer is the oligonucleotide of SEQ ID NO:2, under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA, wherein the amplification is by the polymerase chain reaction method whereby the conditions for the amplification comprise 30-40 cycles of heating the synthesized DNA and a primer pair to 93 to 96° C. for 30 seconds to one minute, 53° to 56° C. for 30 seconds to one minute and 70° to 74° C. for 30 seconds to five minutes, wherein the primer pair consists of the oligonucleotide consisting essentially of SEQ ID NO:10 and the oligonucleotide consisting essentially of SEQ ID NO:2; and c) detecting the amplification of the synthesized DNA, wherein the detection of the amplification of the synthesized DNA is by Southern blot hybridization assay, with a probe consisting essentially of the oligonucleotide of SEQ ID NO:3, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

The present invention further provides a method for detecting the presence of a retrovirus in a biological sample comprising the steps of contacting one to fifty microliters of the unprocessed biological sample with a region of the encephalomyocarditis virus genome as an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; amplifying the synthesized DNA; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

In addition, the present invention provides a method for detecting the presence of a retrovirus in a biological sample comprising the steps of contacting one to fifty microliters of the unprocessed biological sample with a region of the encephalomyocarditis virus genome as an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; amplifying the synthesized DNA by the polymerase chain reaction method whereby the conditions for the amplification comprise 30-40 cycles of heating the synthesized DNA and a primer pair to 93° to 96° C. for 30 seconds to one minute, 53° to 56° C. for 30 seconds to one minute and 70° to 74° C. for 30 seconds to five minutes; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

Also provided in the present invention is a method of detecting the presence of a retrovirus in a biological sample comprising the steps of contacting one to fifty microliters of the unprocessed biological sample with a ribonucleotide of SEQ ID NO:4 and an oligonucleotide of SEQ ID NO:2 under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase is present in the sample; amplifying the synthesized DNA by the polymerase chain reaction whereby the conditions of the amplification comprise about 35 cycles of heating the synthesized DNA and a primer pair consisting of the oligonucleotide of SEQ ID NO:1 and the oligonucleotide of SEQ ID NO:2 to about 95° C. for one minute, about 55° C. for one minute and about 72° C. for one minute; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

Additionally provided is a method of detecting the presence of a retrovirus in a biological sample comprising the steps of contacting one to fifty microliters of the unprocessed biological sample with a ribonucleotide of SEQ ID NO:4 and an oligonucleotide of SEQ ID NO:2 under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase is present in the sample; amplifying the synthesized DNA by the polymerase chain reaction whereby the conditions of the amplification comprise about 35 cycles of heating the synthesized DNA and a primer pair consisting of the oligonucleotide of SEQ ID NO:10 and the oligonucleotide of SEQ ID NO:2 to about 95° C. for one minute, about 55° C. for one minute and about 72° C. for one minute; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

A method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject is also provided, comprising the steps of contacting a biological sample from the subject with a region of the encephalomyocarditis virus genome as an RNA template, a Group M reverse transcriptase inhibiting amount of nevirapine and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase in the sample is not inhibited by the nevirapine; amplifying the synthesized DNA; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample.

Further provided is a method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject comprising the steps of contacting a biological sample from the subject with a region of the encephalomyocarditis virus genome as an RNA template, a Group M reverse transcriptase inhibiting amount of nevirapine and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase in the sample is not inhibited by the nevirapine; amplifying the synthesized DNA by the polymerase chain reaction method whereby the conditions for the amplification comprise 30-40 cycles of heating the synthesized DNA and a primer pair to 93° to 96° C. for 30 seconds to one minute, 53° to 56° C. for 30 seconds to one minute and 70° to 74° C. for 30 seconds to five minutes; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample.

Furthermore, the present invention provides a method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject comprising the steps of contacting a biological sample from the subject with a ribonucleotide of SEQ ID NO:4, an oligonucleotide of SEQ ID NO:2 and a Group M reverse transcriptase inhibiting amount of nevirapine under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase in the sample is not inhibited by the nevirapine; amplifying the synthesized DNA by the polymerase chain reaction whereby the conditions of the amplification comprise about 35 cycles of heating the synthesized DNA and a primer pair consisting of the oligonucleotide of SEQ ID NO:1 and the oligonucleotide of SEQ ID NO:2 to about 95° C. for one minute, about 55° C. for one minute and about 72° C. for one minute; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample.

In addition, the present invention provides a method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject comprising the steps of contacting a biological sample from the subject with a ribonucleotide of SEQ ID NO:4, an oligonucleotide of SEQ ID NO:2 and a Group M reverse transcriptase inhibiting amount of nevirapine under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase in the sample is not inhibited by the nevirapine; amplifying the synthesized DNA by the polymerase chain reaction whereby the conditions of the amplification comprise about 35 cycles of heating the synthesized DNA and a primer pair consisting of the oligonucleotide of SEQ ID NO:10 and the oligonucleotide of SEQ ID NO:2 to about 95° C. for one minute, about 55° C. for one minute and about 72° C. for one minute; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample.

Finally, the present invention provides a kit for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a biological sample of a human immunodeficiency virus-1 infected subject, comprising a region of the encephalomyocarditis virus genome as an RNA template, a Group M reverse transcriptase inhibitor, a complementary DNA primer for reverse transcriptase and a primer pair for polymerase chain reaction.

DETAILED DESCRIPTION OF THE INVENTION

As used in the specification and in the claims, "a" can mean one or more, depending on the context in which it is used.

The present invention provides a method for detecting the presence of a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA; and c) detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

The RNA template can comprise a suitable region of any ribonucleotide sequence such as, for example, the encephalomyocarditis virus genome. As used herein, a "suitable region" means a region of the RNA sequence having no significant secondary structure, less than 50% G-C content and to which complementary DNA primers can be generated which have T_(m) values within the range of reaction temperatures appropriate for the synthesis of a DNA strand, as further described herein. The RNA template can be of a length sufficient to produce a DNA product ranging in size from 100 to 500 base pairs in length and most preferably about 300 base pairs in length. The RNA template can be the ribonucleotide of SEQ ID NO:4.

As used herein, "complementary DNA primer" means an oligonucleotide which anneals to the RNA template in a particular orientation to allow for the synthesis of a nascent DNA strand in the presence of RT in the biological sample under the conditions described herein. Also as used herein, the "conditions" under which a DNA strand is synthesized include the presence of nucleotides, cations and appropriate buffering agents in amounts and at temperatures such that the RNA template and the DNA primer will anneal and oligonucleotides will be incorporated into a synthesized DNA strand if reverse transcriptase is present. More specifically, an example of these conditions is provided in the Examples section. The described conditions have been optimized from other known RT/cDNA synthesis protocols. It is generally known that other conditions can be established for optimization of a particular RT reaction on the basis of protocols well known to one of ordinary skill in the art. The DNA primer can be the reverse primer of a primer pair to be used in a subsequent amplification by PCR, such as, for example, the oligonucleotide of SEQ ID NO:2 (EMCR2).

The biological sample can comprise any biological tissue or body fluid (e.g., cells, serum, plasma, semen, urine, saliva, sputum, cerebrospinal fluid). The synthesized DNA strand can be amplified by any of the amplification protocols known in the art now or in the future, including but not limited to the polymerase chain reaction (PCR) (17), the ligation amplification reaction (LAR) (21), the ligase-based amplification system (LAS) (22), the self-sustained sequence replication (3SR) system (23), the transcription-based based amplification system (TAS) (24) and the Qβ replicase amplification method (25).

For amplification of the synthesized DNA by PCR, the conditions for amplification can include 30 to 40 (most preferably 35) cycles of heating the synthesized DNA and a primer pair to 93° to 96° C. (most preferably 95° C.) for 30 seconds to one minute (most preferably one minute), 53° to 56° C. (most preferably 55° C.) for 30 seconds to one minute (most preferably one minute) and 70° to 74° C. (most preferably 72° C.) for 30 seconds to five minutes (most preferably one minute).

As used herein, "a primer pair" refers to two primers, one having a forward designation and the other having a reverse designation relative to their respective orientations on a double-stranded DNA molecule which consists of a sense and antisense sequence, such that under the amplification conditions described herein, the forward primer anneals to and primes amplification of the sense sequence and the reverse primer anneals to and primes amplification of the antisense sequence. Primers can be selected for use in the amplification reaction on the basis of having less than 50% G-C content, having minimal complementarity with other primers in the reaction (to minimize the formation of primer dimers) and having T_(m) values within the range of reaction temperatures appropriate for PCR. In addition, primers can be selected to anneal with specific regions of the RNA template such that the resulting DNA amplification product ranges in size from 100 to 500 base pairs in length and most preferably around 300 base pairs in length. For example, in the conditions described above, the primer pair can consist of the oligonucleotide of SEQ ID NO:1 (EMCF1) as the forward primer and the oligonucleotide of SEQ ID NO:2 (EMCR2) as the reverse primer. Alternatively, the primer pair can consist of the oligonucleotide: 5'CTCCCATCAGGTTGTGCAGCGACC3' (SEQ ID NO:10) (EMCF1') as the forward primer and the oligonucleotide of SEQ ID NO:2 (EMCR2) such that the resulting PCR amplification product is the oligonucleotide of SEQ ID NO:11.

As used herein, "detecting" or "detection" of the amplified DNA refers to quantitatively or qualitatively determining the presence of the amplified DNA strand which is only synthesized if RT is present in the biological sample. The amplification of the synthesized DNA can be detected by any method for the detection of DNA known in the art. For example, detection of the amplified DNA can be by Southern blot hybridization assay, by visualization of PCR products of specific molecular weight on ethidium bromide stained agarose gels, by measurement of the incorporation of radiolabeled nucleotides into the synthesized DNA strand by autoradiography or scintillation measurement, by ELISA modified for the capture of a detectable moiety bound to the amplified DNA, or any other detection method known to one of ordinary skill in the art.

For detection by Southern blot hybridization assay, the synthesized DNA can be detected by a probe specific for the DNA synthesized from the template. For example, such a specific probe can consist essentially of the oligonucleotide of SEQ ID NO:3 (EMCP1). A Southern blot hybridization protocol for use in the invention is demonstrated in the Examples.

The present invention provides a method for detecting the presence of a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with a suitable region of the encephalomyocarditis virus genome as an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA; and c) detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

The present invention also provides a method of detecting the presence of a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA by the polymerase chain reaction method whereby the conditions for the amplification comprise 30-40 cycles of heating the synthesized DNA and a primer pair to 93° to 96° C. for 30 seconds to one minute, 53° to 56° C. for 30 seconds to one minute and 70° to 74° C. for 30 seconds to five minutes; and c) detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

The present invention further provides a method for detecting the presence of a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with a region of the encephalomyocarditis virus genome as an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA by the polymerase chain reaction method whereby the conditions for the amplification comprise 30-40 cycles of heating the synthesized DNA and a primer pair to 93° to 96° C. for 30 seconds to one minute, 53° to 56° C. for 30 seconds to one minute and 70° to 74° C. for 30 seconds to five minutes; and c) detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

As an example, the present invention can provide a method for detecting a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with a suitable region of the encephalomyocarditis virus genome as an RNA template, wherein the RNA template is the ribonucleotide of SEQ ID NO:4 and a complementary DNA primer, wherein the primer is the oligonucleotide of SEQ ID NO:2, under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA, wherein the DNA is amplified by the polymerase chain reaction under conditions which comprise about 35 cycles of heating the synthesized DNA and a primer pair to 95° C. for one minute, 55° C. for one minute and 72° C. for one minute, wherein the primer pair consists of the oligonucleotide consisting essentially of the SEQ ID NO:1 and the oligonucleotide consisting essentially of the SEQ ID NO:2; and c) detecting the amplification of the synthesized DNA, wherein the amplification is detected by Southern blot hybridization assay with a probe consisting essentially of the oligonucleotide of SEQ ID NO:3.

Further provided is a method of detecting the presence of a retrovirus in a biological sample comprising the steps of: a) contacting the biological sample with an RNA template, wherein the RNA template is a region of the encephalomyocarditis virus which consists of the ribonucleotide of SEQ ID NO:4 and a complementary DNA primer, wherein the primer is the oligonucleotide of SEQ ID NO:2, under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; b) amplifying the synthesized DNA, wherein the amplification is by the polymerase chain reaction method whereby the conditions for the amplification comprise 30-40 cycles of heating the synthesized DNA and a primer pair to 93 to 96° C. for 30 seconds to one minute, 53° to 56° C. for 30 seconds to one minute and 70° to 74° C. for 30 seconds to five minutes, wherein the primer pair consists of the oligonucleotide consisting essentially of SEQ ID NO:10 and the oligonucleotide consisting essentially of SEQ ID NO:2; and c) detecting the amplification of the synthesized DNA, wherein the detection of the amplification of the synthesized DNA is by Southern blot hybridization assay, with a probe consisting essentially of the oligonucleotide of SEQ ID NO:3.

The present invention also provides a method for detecting the presence of a retrovirus in a biological sample comprising the steps of contacting one to fifty microliters of the unprocessed biological sample with a region of the encephalomyocarditis virus genome as an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; amplifying the synthesized DNA; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample. As claimed, the amount of the unprocessed sample can be between one and fifty microliters of sample and more preferably between two and fifty microliters of sample, the most preferred amount being two microliters. The unprocessed biological sample most preferably is plasma or serum but can also be any biological fluid from which cells can be removed and can be from various sources including, but not limited to, culture supernatant, cerebrospinal fluid, semen, urine, saliva, sputum or other body fluids (e.g., synovial fluid, pleural fluid, etc).

Further provided in the present invention is a method for detecting the presence of a retrovirus in a biological sample comprising the steps of contacting one to fifty microliters of the unprocessed biological sample with a region of the encephalomyocarditis virus genome as an RNA template and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase is present in the sample; amplifying the synthesized DNA by the polymerase chain reaction method whereby the conditions for the amplification comprise 30-40 cycles of heating the synthesized DNA and a primer pair to 93° to 96° C. for 30 seconds to one minute, 53° to 56° C. for 30 seconds to one minute and 70° to 74° C. for 30 seconds to five minutes and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

A method for detecting the presence of a retrovirus in a biological sample is also provided which comprises the steps of contacting one to fifty microliters of the unprocessed biological sample with a ribonucleotide of SEQ ID NO:4 and an oligonucleotide of SEQ ID NO:2 under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase is present in the sample; amplifying the synthesized DNA by the polymerase chain reaction whereby the conditions of the amplification comprise about 35 cycles of heating the synthesized DNA and a primer pair consisting of the oligonucleotide of SEQ ID NO:1 and the oligonucleotide of SEQ ID NO:2 to about 95° C. for one minute, about 55° C. for one minute and about 72° C. for one minute; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

A method for detecting the presence of a retrovirus in a biological sample is also provided which comprises the steps of contacting one to fifty microliters of the unprocessed biological sample with a ribonucleotide of SEQ ID NO:4 and an oligonucleotide of SEQ ID NO:2 under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase is present in the sample, amplifying the synthesized DNA by the polymerase chain reaction whereby the conditions of the amplification comprise about 35 cycles of heating the synthesized DNA and a primer pair consisting of the oligonucleotide of SEQ ID NO:10 and the oligonucleotide of SEQ ID NO:2 to about 95° C. for one minute, about 55° C. for one minute and about 72° C. for one minute; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of reverse transcriptase in the biological sample, thus indicating the presence of a retrovirus in the biological sample.

The Amp-RT method of the present invention detects all types of retroviruses, including HIV-1 variants, the subtypes of Group M and the divergent Group O. Most preferably, nevirapine, a non-nucleoside RT inhibitor previously shown to be specific for HIV-1 (36,38) can be used for differentiating between HIV-1 Group M and Group O viruses. In addition, any other compound which selectively inhibits either Group M RT or Group O RT but not both, is suitable for the claimed method. For example, TIBO derivatives (39,40) could be used in the present differentiation assay.

Also provided in the present invention is a method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject comprising the steps of contacting a biological sample from the subject with a region of the encephalomyocarditis virus genome as an RNA template, a Group M reverse transcriptase inhibiting amount of nevirapine and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase in the sample is not inhibited by the nevirapine; amplifying the synthesized DNA by the polymerase chain reaction method whereby the conditions for the amplification comprise 30-40 cycles of heating the synthesized DNA and a primer pair to 93° to 96° C. for 30 seconds to one minute, 53° to 56° C. for 30 seconds to one minute and 70° to 74° C. for 30 seconds to five minutes; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample.

In addition, the present invention provides a method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject comprising the steps of contacting a biological sample from the subject with a region of the encephalomyocarditis virus genome as an RNA template, a Group M reverse transcriptase inhibiting amount of nevirapine and a complementary DNA primer under conditions whereby the RNA template and the DNA primer will anneal and a DNA strand will be synthesized as an extension from the DNA primer if reverse transcriptase in the sample is not inhibited by the nevirapine; amplifying the synthesized DNA; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample.

Furthermore, the present invention provides a method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject comprising the steps of contacting a biological sample from the subject with a ribonucleotide of SEQ ID NO:4, an oligonucleotide of SEQ ID NO:2 and a Group M reverse transcriptase inhibiting amount of nevirapine under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase in the sample is not inhibited by the nevirapine; amplifying the synthesized DNA by the polymerase chain reaction whereby the conditions of the amplification comprise about 35 cycles of heating the synthesized DNA and a primer pair consisting of the oligonucleotide of SEQ ID NO:1 and the oligonucleotide of SEQ ID NO:2 to about 95° C. for one minute, about 55° C. for one minute and about 72° C. for one minute; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample.

In addition, the present invention provides a method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject comprising the steps of contacting a biological sample from the subject with a ribonucleotide of SEQ ID NO:4, an oligonucleotide of SEQ ID NO:2 and a Group M reverse transcriptase inhibiting amount of nevirapine under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase in the sample is not inhibited by the nevirapine; amplifying the synthesized DNA by the polymerase chain reaction whereby the conditions of the amplification comprise about 35 cycles of heating the synthesized DNA and a primer pair consisting of the oligonucleotide of SEQ ID NO:10 and the oligonucleotide of SEQ ID NO:2 to about 95° C. for one minute, about 55° C. for one minute and about 72° C. for one minute; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample.

Finally, the present invention provides a kit for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a biological sample of a human immunodeficiency virus-1 infected subject, comprising the enzymes, buffering agents, cations and oligonucleotides well known in the art for carrying out RT and PCR reaction. The kit also comprises a suitable region of the encephalomyocarditis virus genome as an RNA template, a Group M reverse transcriptase inhibitor, a complementary DNA primer for reverse transcriptase and a primer pair for polymerase chain reaction. The RNA template, the complementary DNA primer, the reverse transcriptase inhibitor and the primers of the primer pair can each be in separate containers or all or any combination of these components can be combined in a single container. The complementary DNA primer can be the oligonucleotide of SEQ ID NO:2 (EMCR2), the RNA template can be the ribonucleotide of SEQ ID NO:4 and the primer pair can consist of the oligonucleotide of SEQ ID NO:1 (EMCF1) and the oligonucleotide of SEQ ID NO:2 (EMCR2). Alternatively, the primer pair can consist of the oligonucleotide of SEQ ID NO:10 (EMCF1') and the oligonucleotide of SEQ ID NO:2 (EMCR2). The Group M reverse transcriptase inhibitor can be nevirapine.

Additionally provided is a kit for detecting the presence of a retrovirus in a biological sample, comprising the enzymes, buffering agents, cations and oligonucleotides well known in the art for carrying out RT and PCR reactions. The kit also comprises a suitable region of the encephalomyocarditis virus genome as an RNA template and a complementary DNA primer for reverse transcriptase and a primer pair for polymerase chain reaction. The RNA template, the complementary DNA primer and the primers of the primer pair can each be in separate containers or all or any combination of these components can be combined in a single container. The complementary DNA primer can be the oligonucleotide of SEQ ID NO:2 (EMCR2), the RNA template can be the ribonucleotide of SEQ ID NO:4 and the primer pair can consist of the oligonucleotide consisting essentially of SEQ ID NO:1 (EMCF1) and the oligonucleotide consisting essentially of SEQ ID NO:2 (EMCR2). Alternatively, the primer pair can consist of the oligonucleotide of SEQ ID NO:10 (EMCF1') and the oligonucleotide of SEQ ID NO:2 (EMCR2).

Also provided in the present invention are the isolated nucleic acids comprising the oligonucleotide sequences set forth in the Sequence Listing as SEQ ID NOS:1, 2, 3, 4, 6, 10 and 11. By "isolated nucleic acid" is meant nucleic acid molecules that are substantially free of the other nucleic acids and other components, such as bacterial proteins, found in the naturally occurring bacterium. Separation techniques for isolating nucleic acids from bacteria as well as other organisms are well known in the art, as described, e.g., in the Examples section herein.

The present invention has additional applications based on the basic inventive principle that RT can be detected and quantitated in a biological sample. One application of this principle is the differential identification of retroviruses on the basis of the specific reactivity of the detected RT with antibodies against different retroviral RTs (for example, antibodies which can distinguish RT produced by HIV-1 or HIV-2 in infected individuals). Each retrovirus has a distinct RT, to which specific antibodies can be generated, thereby permitting identification of the specific retrovirus. The method of the present invention can be employed to first detect the presence of RT and various antibodies specific for RTs of different retroviruses can then be added to the biological sample to identify the type of retrovirus present. An antibody of known RT specificity will bind the RT present in the biological sample if the RT is produced by the virus to which the antibody is specific and will inhibit its activity, resulting in no DNA synthesis in the presence of antibody.

Another application of the present invention is screening patients for resistance to drug therapy. The susceptibility of RT to anti-RT drugs can be monitored over time in a patient receiving anti-RT drug therapy. The present invention can be employed to detect the emergence of anti-RT drug resistance in a patient by direct testing of the patient's serum for RT activity as an indicator of the susceptibility of the RT in the patient's serum to the anti-RT drug(s) used. If drug resistance is detected, alternative treatment strategies may be implemented. This invention obviates the need for the lengthy and labor-intensive culture methods currently used to study drug resistance in patients.

A third application of the present invention is the monitoring of virus load in patients infected with biological entities which produce RT. Quantitative measurement of RT over time can be correlated with survival and/or recovery rates in patients with illnesses caused by theses entities, for the purpose of following disease progression and prognosing the patient's illness.

The present invention is more particularly described in the following examples which are intended as illustrative only since numerous modifications and variations therein will be apparent to those skilled in the art.

EXAMPLES

The following examples are intended to illustrate, but not limit, the invention. While the protocols described are typical of those that might be used, other procedures known to those skilled in the art may be alternatively employed.

Viruses

The retroviruses used in this study were prepared as follows. HIV-1 Lai and simian immunodeficiency virus (SIVB670) were propagated in peripheral blood lymphocytes (PBLs). Caprine arthritis encephalitis virus (CAEV-63) was propagated in fetal goat synovial membrane cells. HTLV-I and HTLV-II were obtained from supernatants of MT-2 and Mo-T cell lines; simian retroviruses types 1 and 2 (SRV-1 and SRV-2) were grown in Raji cells; gibbon ape leukemia virus (GALV) was grown in Jurkat cells and simian foamy virus type 3 (SFV-3) was grown in the Cf2Th cell line.

In vitro transcription of the RNA template

An RNA sequence from the encephalomyocarditis virus (EMCV) was used as template and was generated from a plasmid vector obtained from Novagen (Madison, Wis., USA). A small EMCV sequence (350 bp) (SEQ ID NO:4) was amplified from the plasmid, using standard PCR conditions and the primer pair T7-EMCF1 (SEQ ID NO:6) and EMCR2 (SEQ ID NO:2). The sequence of T7-EMCF1 (SEQ ID NO:6) was:

5'GGTACCTAATACGACTCACTATAGGGAGACATTAGCCATTTCAACCCAT3' and that of EMCR2 (SEQ ID NO:2) was:

5'GTTCATGACAGGCCGATACAGAGG3'.

To allow the in vitro transcription of this PCR product, the sense primer, EMCF1: 5'CATTAGCCATTTCAACCCAT3' (SEQ ID NO:1), was modified at the 5' end by adding a T7 promoter sequence: 5'GGTACCTAATACGACTCACTAT-3' (SEQ ID NO:5).

The EMCV-amplified product was then transcribed with the large scale T7 transcription kit from Novagen according to the manufacturer's instructions. The DNA in the RNA preparation was subsequently digested twice with 20 units of RNase-free DNase (Promega) at 37° C. for 60 minutes and the DNase was inactivated by heating at 95° C. for ten minutes. The purity of the RNA preparation was checked for residual DNA contamination by PCR amplification with EMCF1 (SEQ ID NO:1) and EMCR2 (SEQ ID NO:2) and subsequent Southern blot hybridization to the ³² P-end-labeled internal probe EMCP1 (SEQ ID NO:3): 5'TGCTCTCACCTTATCAAAATCCAAT3'.

Amp-RT

Twenty ul or less of the biological sample to be tested was added to 40 ul of RT buffer containing 10 ng of RNA template, 10 units of RNasin, 0.06% NP-40, 200 ng primer (EMCR2, SEQ ID NO:2), 0.8 mM EGTA, 200 μM of each dNTP, 2 mM DTT, 50 mM Tris-HCl, 50 mM KCl, and 10 mM MgCl₂. The reaction was incubated at 37° C. for two hours and then heated at 95° C. for ten minutes to inactivate any RT activity. A volume of 50 ul of standard PCR buffer (17) containing 0.5 units of Taq polymerase and 200 ng of the sense primer without the T7 sequence (EMCF1, SEQ ID NO:1) was added to this mixture. The reaction was cycled 35 times at 95° C. for one minute, 55° C. for one minute and 72° C. for one minute. Twenty ul of the reaction product was electrophoresed in 1.8% agarose gels and Southern blot hybridized to a ³² P-end-labeled internal probe (EMCP1, SEQ ID NO:3) at 42° C. overnight. The blots were washed in 2× SSC (NaCl and sodium citrate), 0.5% sodium dodecyl sulfate (SDS) for one to two hours. The blots were exposed from six to 24 hours.

To check the integrity and the purity of the RNA template preparation, RT reactions were carried out using the EMCV RNA template (SEQ ID NO:4) and an HIV-1 virus stock as the RT source. While the HIV-1 reactions were positive, control reactions which had no HIV-1, or which were pretreated with RNase before the addition of HIV-1, were all negative. These negative results indicated that the underlying reaction of Amp-RT was RNA-dependent and that the RNA template and other assay components were free of any contaminating target DNA. To further confirm that the reaction was mediated by RT, Amp-RT reactions were prepared by using HIV-1 culture supernatant in the presence of 2 ug of tetrahydroimidazo-benzodiazepin (TIBO) compounds, which are non-nucleoside RT inhibitors (2). The results demonstrated inhibition of the Amp-RT reaction only in the presence of the TIBO compounds, while the DNA polymerase activity of Taq in the control amplification reactions was not affected.

Comparative sensitivity analysis of Amp-RT

Many specific and generic assays are currently used to detect the presence of retroviruses. To compare the relative sensitivities of these assays to Amp-RT, serial 10-fold dilutions of an HIV-1 culture supernatant were made in culture medium and then divided into equal aliquots. Separate aliquots were subjected to testing by standard RT assay, branched DNA detection, p24 antigen capture, 50% tissue culture infective dose (TCID₅₀) determination, RT-PCR and Amp-RT.

Standard RT assay

RT activity was measured in culture supernatant with the template primer of poly(rA).oligo dT according to the methods of Willey et al. (3). The enzymatic activity was assessed by measuring the incorporated tritiated thymidine monophosphate.

Branched DNA (bDNA) detection of HIV-1

Branched DNA (bDNA) detection of HIV-1 was performed according to the manufacturer's instructions (Chiron, Emryville, Calif., USA). A cutoff of 5,000 RNA equivalents/ml was used, as recommended by the manufacturer.

p24 antigen capture

Levels of base dissociated-p24 antigens of HIV-1 were determined by a commercially available ELISA kit from Organon Technika (North Carolina, USA).

TCID₅₀ determination

The TCID₅₀ of the HIV-1 viral stock was determined on PBLs as previously described by McDougal et al. (26).

RT-PCR

Particle-associated HIV-1 genomic RNA in culture supernatant was extracted with phenol/chloroform, precipitated with ethanol and reconstituted in 40 ul of RT buffer 50 mM Tris-Cl (pH 8.3), 20 mM KCl, 10 mM MgCl₂ ! (15). RNA was further digested with 5 units of DNase-I (Promega) in the presence of 10 mM sodium acetate at 37° C. for 30 minutes. DNase was inactivated by heating at 95° C. for ten minutes. For reverse transcription, 10 ul of RNA was added to 20 ul of the RT mixture, containing 10 mM DTT, 20 units RNasin, 0.875 mM each of GTP, ATP, CTP and TTP, 200 ng of reverse primer (SK39, SEQ ID NO:8) and 0.02 units of AMV-reverse transcriptase. The mixture was reverse transcribed at 42° C. for 45 minutes. Controls included 10 ul aliquots that were not reverse transcribed. All samples were then amplified by PCR in 100 ul reaction volumes for 35 cycles, using SK38/SK39 (SEQ ID NOS:7 and 8) as primers and the amplified products were Southern blot hybridized to the ³² P-labeled SK19 (SEQ ID NO:9) probe (27).

The results, shown in Table 1, demonstrated that Amp-RT was the most sensitive assay and was 100,000 times more sensitive than the standard RT assay, 10,000 times more sensitive than the bDNA detection system and the p24 antigen capture assay and 100 times more sensitive than TCID₅₀ and RT-PCR. The p24 concentration in the undiluted HIV-1 sample was found to be 1.6 ng.

Testing of clinical samples with Amp-RT

Forty-two serum samples from HIV-1 seropositive individuals enrolled in a study of the natural history of HIV in homosexual men in Atlanta, Ga., USA (28) were tested by Amp-RT. The clinical stage of the HIV-1 infection in these men was determined on the basis of the Centers for Disease Control and Prevention (CDC) revised classification system (29). Laboratory markers, including CD4+ lymphocyte counts and percentage of CD4+ lymphocytes in the blood, were determined by standard flow cytometric methods. Serum samples from 20 healthy individuals who were HTLV-I/II and HIV-1 seronegative were included as controls.

Preliminary experiments using normal human serum spiked with HIV-1 were all Amp-RT negative and indicated that preparation of serum samples for Amp-RT requires special conditions different from those described for culture supernatant. For instance, even small volumes (5-20 ul) of serum or plasma could not be directly tested by Amp-RT because of protein precipitation that develops during the high temperature stage of the PCR cycle. Therefore, to avoid this problem, sera were ultracentrifuged and the Amp-RT assay was performed using the viral pellet.

For testing of culture supernatant, 20 ul or less was used for the RT reaction. For testing serum or plasma samples, 0.5 ml was diluted 10-fold in DEPC-treated phosphate buffered saline, clarified by centrifugation at 1,000 g for 10 minutes and then ultracentrifuged at 44,000 g for one hour. The pellet was suspended in 50 ul of RT buffer containing 0.6% NP-40 for 15 minutes and aliquots of 5-45 ul were used in the Amp-RT assay.

The results of testing serum samples indicated that Amp-RT was able to detect RT activity in 36 (85.7% ) serum samples (Table 2), 31 of which (86.1%) had detectable p24 antigen. This high sensitivity was also coupled with a high specificity since none of the HIV-1/HTLV seronegative samples were positive. Of the six samples from patients classified as A1, three were Amp-RT positive (50%), while five of seven (71.4%) and 25 of 26 (96.1%) of the samples from patients classified as B2 and C3, respectively, were Amp-RT positive.

Testing of the hepatitis B virus (HBV) by Amp-RT

Because the polymerase gene of HBV has been reported to possess RT-like activity (30), Amp-RT was employed to detect the HBV-associated RT activity. Serum samples from 21 HBV-infected individuals were selected, including 11 samples with detectable HBe antigen (Abbott HBe EIA, Chicago, USA) and ten other samples with no detectable HBe antigen. .

Despite the documented presence of HBV virions in 11 serum specimens, none of the samples yielded positive results by Amp-RT analysis. These negative results exclude the possibility of the HBV-associated RT interfering in the Amp-RT assay, at least under these conditions, and therefore confirm the specificity range of the assay for the detection of only retroviral RTs.

Detection of different retroviruses by Amp-RT.

The ability of Amp-RT to detect a wide variety of retroviruses representing members of all three retroviral subfamilies was investigated. The lentiviruses tested included HIV-1, SIV and CAEV. HTLV-I, HTLV-II, GALV, SRV-1 and SRV-2 were representative of the oncoviruses and SFV-3 was representative of the spumaviruses. Amp-RT was capable of detecting all retroviruses tested. Most importantly, viruses such as HTLV-I, HTLV-II and GALV, which are typically difficult to detect with the standard RT methodology, were easily identified with this assay.

These viruses could be detected by Amp-RT in dilutions containing 0.04 to 0.00004 ul of the original unconcentrated culture supernatant. The serial dilutions of the tested retroviruses were made in supernatant from uninfected cell lines (Hut-78, A301 or U937). All three supernatants consistently tested negative, as can be seen from the end point dilutions of the tested retroviruses.

Amp-RT by direct plasma testing.

Plasma samples from 55 HIV-1 infected persons, ten seroconversion panels and 100 uninfected controls were studied. Two micoliter volumes of unprocessed plasma were tested in duplicate by the Amp-RT protocol as described above. The viral load was determined from a standard curve generated by known numbers of recombinant HIV-1 RT molecules and was expressed as equivalents of recombinant RT (rRT) molecules/ml. For comparison, RNA virus loads were also determined by the NASBA commercial assay (Organon). The sensitivity was 80.2% for Amp-RT and 78.6% for NASBA. The specificity of Amp-RT was 100%. The Pearson correlation coefficient between RT and RNA levels was 0.66 (95% CI (0.51, 0.77)) for the entire study population, 0.79 (95% CI (0.66, 0.88)) for the seroconversion panels and 0.54 (95% CI (0.21, 0.75)) for 35 clinical samples. Interestingly, analysis of ratios of RT to RNA levels showed a one log higher ratio in the seroconversion samples (95% CI (0.51, 1.57)), p<0.001). The differences seen in RT/RNA ratios provide evidence for variabilities in virus loads that were previously undetectable by RNA-based methods.

Analysis of nevirapine sensitivity in group M and O virus isolates by the Amp-RT assay.

To measure the sensitivity of group M and group O viruses to nevirapine (Boehringer Mannheim), the Amp-RT assay as described herein was used to measure the enzymatic activity of RT of these viruses in the presence or absence of the drug. Ten microliters of culture supernatants were added to 40 μl of RT buffer containing 10 ng of RNA template, 10 units of Rnasin (Promega, Wis.), 0.06% NP-40, 100 ng of the antisense primer EMCR2 (SEQ ID NO:2), 0.8 mM EGTA, 2 mM dithiothreitol, 50 mM Tris-HCl, 10 mM MgCl₂ and 200 μM of each dNTP with or without 100 μM of nevirapine. The reaction was incubated at 37° C. for one hour and heated at 95° C. for ten minutes. The products of the RT reaction were PCR amplified for 35 cycles at 95° C. for one minute, 55° C. for one minute and 72° C. for one minute after the addition of 50 μl of PCR buffer containing 2.5 units of Taq polymerase, 100 ng of sense primer EMCF1': 5'CTCCCATCAGGTTGTGCAGCGACC3' (SEQ ID NO:10). Twenty microliters of the reaction product was electrophoresed in 1.8% agarose gels and Southern blot hybridized to ³² P-end labeled internal probe EMCP1 (SEQ ID NO:3). For qualitative detection, blots were exposed on autoradiographic film for 12-16 hours. For quantitative detection, blots were exposed for 3-6 hours and their radioactivities were read and measured by a Phosphor Imager (Model # 400E, Molecular Dynamics, Inc., CA). Amp-RT signal intensity was reported as relative pixel values as described previously (42)

Nevirapine at 100 μM was found to inhibit the Amp-RT activity of 21 group M reference isolates of A through F subtypes. In contrast, the group O reference isolate, MVP5180 (NIH AIDS Research and Reference Reagent Program Catalog), was found to be resistant to nevirapine. Applicability to serum screening was evaluated in 10 group O-infected and 10 group M-infected persons. The serum samples were tested according to the direct Amp-RT assay with unprocessed 2 μl samples, as described herein. All group O sera were Amp-RT positive in the presence and absence of nevirapine. In contrast, Amp-RT reactions from all group M sera were positive only in the absence of nevirapine.

Side by side comparison of previously published RT assays

To demonstrate that the assay of the present invention provides increased specificity and sensitivity in comparison to other published RT assays 18,19!, a side by side comparison of these assays can be performed. These assays differ in the particular RNA template sequence, primer sequences, RT buffer compositions, amplification conditions, detection conditions and sample preparation used. Therefore, for a comparison of the two assays, a panel of serum samples from HIV-1 seropositive individuals and from HIV-1 and HTLV-I/II negative individuals can be tested according to the teachings of the present assay and each other assay. Positive controls can include normal human serum spiked with HIV-1 virus particles. The specificity and sensitivity of these assays can then be computed and compared.

Experiments were conducted comparing the performance of the following three ultrasensitive methods for measuring RT activity: 1) the Amp-RT assay of the present application; 2) the RT-PCR assay according to the protocol described in Silver et al. (19); and 3) the PERT assay according to the protocol described in Pyra et al. (18). The sensitivity and specificity of the three assays were compared on two sets of serum samples, one set of samples from fourteen subjects determined to be negative for all known human retroviruses (HTLV I, HTLV II, HIV-1 and HIV-2) and one set of samples from fourteen HIV-1 positive subjects.

Virus pellets prepared from 50 microliters of serum were used in the testing of all three methods. The method of Silver et al. does not describe a protocol for preparation of serum samples for testing. Thus, the Amp-RT protocol for sample preparation was used for the method of Silver et al.

Amp-RT testing was carried out according to the present method. Specifically, 100 μl of each serum sample was diluted 10-fold in DEPC-treated phosphate buffered saline, clarified by centrifugation in a microfuge at approximately 15,000 rpm for ten minutes and then ultracentrifuged at 44,000 g for one hour. The pellet was suspended in 50 μl of RT buffer containing 0.6% NP-40 for 15 minutes. Twenty-five μl of the resuspended pellet sample was added to 25 μl of RT buffer containing 10 ng of RNA template, 10 units of Rnasin, 200 ng primer (EMCR2, SEQ ID NO:2), 0.8 mM EGTA, 200 μM of each dNTP, 2 mM DTT, 50 mM Tris-HCl, 50 mM KCl, and 10 mM MgCl₂. The reaction was incubated at 37° C. for two hours and then heated at 95° C. for ten minutes to inactivate any RT activity. A volume of 50 μl of standard PCR buffer (17) containing 0.5 units of Taq polymerase and 200 ng of the primer EMCF1' (SEQ ID NO:10) was added to this mixture. The reaction was cycled 35 times at 95° C. for one minute, 55° C. for one minute and 72° C. for one minute. Twenty μl of the reaction product was electrophoresed in 1.8% agarose gels and Southern blot hybridized to a ³² P-end-labeled internal probe (EMCP1, SEQ ID NO:3) at 42° C. overnight. The blots were washed in 2× SSC (NaCl and sodium citrate), 0.5% sodium dodecyl sulfate (SDS) for one to two hours. The blots were exposed from six to 24 hours.

All samples were randomly selected and tested in duplicate. Results were interpreted as positive when duplicate test results were positive. Samples for which the duplicate results were either both negative or discordant were classified as negative.

The results of these comparative studies are described in Table 3. Specifically, the data in Table 3 demonstrate that of the 14 negative sera tested, two of these samples (14.2%) were shown as falsely positive by AMP-RT, four of these samples (28.5%) were shown as falsely positive by the RT-PCR assay of Silver et al. and 12 of these samples (85.7%) were shown as falsely positive by the PERT assay of Pyra et al. These data indicate that the AMP-RT assay has much greater specificity (fewer false positives) than either the Silver et al. assay or the Pyra et al. assay. The false positives seen in the Silver et al. and Pyra et al. assays appear to represent background noise.

The data in Table 3 further demonstrate that the Amp-RT assay has greater sensitivity (fewer false negatives) than either the Silver et al. or Pyra et al. assays. Specifically, of the HIV-1 positive serum samples tested, 0 of 14 samples (0%) were shown as falsely negative by the Amp-RT assay, 5 of 14 samples (35.7%) were shown as falsely negative by the RT-PCR assay of Silver et al. and 3 of 13 samples (23%) were shown as falsely negative by the PERT assay of Pyra et al.

In summary, these data demonstrate that the Amp-RT assay taught herein is not only more specific, but is also more sensitive for the detection of RT in serum samples than the RT-PCR assay of Silver et al. or the PERT assay of Pyra et al.

Furthermore, the Amp-RT method of the present invention using unprocessed plasma as the sample was also shown to have greater specificity and sensitivity than the PCR-RT method of Silver et al. or the PERT method of Pyra et al. Specifically, the claimed Amp-RT assay was conducted as described above, but with two microliters of unprocessed serum from the same groups described above as the sample. The methods of Silver et al. and Pyra et al. were carried out as published with a two microliter unprocessed serum sample from these same groups.

The data in Table 4 show that, of the negative serum samples tested, 0 of 14 samples (0%) was shown as falsely positive by the Amp-RT assay, 14 of 14 samples (100%) were shown as falsely positive by the RT-PCR assay of Silver et al. and 7 of 7 samples (100%) were shown as falsely positive by the PERT assay of Pyra et al. In addition, of the positive serum samples tested, 0 of 14 samples (0%) were shown as falsely negative by the Amp-RT assay, 1 of 7 samples (14%) were shown as falsely negative by the RT-PCR assay of Silver et al. and 2 of 7 samples (29%) were shown as falsely negative by the PERT assay of Pyra et al. Thus, the direct Amp-RT method of the present invention is more specific and more sensitive in detecting RT in two microliters of unprocessed serum than the methods of Silver et al. and Pyra et al.

Throughout this application various publications are referenced by numbers within parentheses. Full citations for these publications are as follows. The disclosures of these publications in their entireties are hereby incorporated by reference into this application in order to more fully describe the state of the art to which this invention pertains.

Although the present process has been described with reference to specific details of certain embodiments thereof, it is not intended that such details should be regarded as limitations upon the scope of the invention except as and to the extent that they are included in the accompanying claims.

                  TABLE 1                                                          ______________________________________                                         Comparison of the sensitivity of Amp-RT in the detection of HIV-1              with other generic and virus-specific methods.                                 HIV-1 Std.                                                                     dilution                                                                             RT      bDNA    p24 ag                                                                               TCID.sub.50                                                                           RT-PCR Amp-RT                               ______________________________________                                         10.sup.0                                                                             +       +       +     +      +      +                                    10.sup.-1                                                                            +       +       +     +      +      +                                    10.sup.-2                                                                            +       +       +     +      +      +                                    10.sup.-3                                                                            -       +       +     +      +      +                                    10.sup.-4                                                                            -       -       -     +      +      +                                    10.sup.-5                                                                            -       -       -     +      +      +                                    10.sup.-6                                                                            -       -       -     -      -      +                                    10.sup.-7                                                                            -       -       -     -      -      +                                    10.sup.-8                                                                            -       -       -     -      -      -                                    ______________________________________                                    

                  TABLE 2                                                          ______________________________________                                         Detection of RT activity by Amp-RT in serum samples from HIV-1                 infected individuals characterized by clinical stage, CD4 + lymphocyte         counts in the peripheral blood and amount of p24 antigen in the serum.                                             Clinical                                   No  Patient ID                                                                              p24 (pg/ml)                                                                              % CD4 CD4 count                                                                             Stage*                                                                               Amp-RT                               ______________________________________                                          1  69877    NEG       27    830    A1    NEG                                   2  82850    NEG       23    699    A1    P                                     3  69878    141       33    566    A1    P                                     4  77913    NEG       25    599    A1    P                                     5  111380   49        27    778    A1    NEG                                   6  111318   49        28    539    A1    NEG                                   7  85987    141       23    348    A2    P                                     8  66583    55        13    286    A2    P                                     9  62303    42        12    341    B2    P                                    10  71172    56        22    281    B2    NEG                                  11  71245    100       11    208    B2    P                                    12  77149    44        16    282    B2    P                                    13  86563    141       14    286    B2    P                                    14  66994    NEG       25    260    B2    NEG                                  15  57589    141       18    370    B2    P                                    16  21149    NEG       10    97     B3    P                                    17  70145    8         5     26     C3    NEG                                  18  84300    141       1     4      C3    P                                    19  111207   N         10    103    C3    P                                    20  67365    141       5     24     C3    P                                    21  96215    40        6     80     C3    P                                    22  120979   141       3     19     C3    P                                    23  20525    73        3     22     C3    P                                    24  736      103       8     50     C3    P                                    25  1837     158       3     6      C3    P                                    26  3125     150       5     12     C3    P                                    27  3369     33        1     1      C3    P                                    28  20577    85        6     123    C3    P                                    29  20525    73        3     22     C3    P                                    30  20577    85        6     123    C3    P                                    31  20709    158       10    42     C3    P                                    32  20876    80        7     57     C3    P                                    33  21156    124       14    106    C3    P                                    34  21196    24        8     48     C3    P                                    35  21684    45        4     25     C3    P                                    36  23505    64        4     19     C3    P                                    37  23507    15        3     52     C3    P                                    38  24462    149       6     41     C3    P                                    39  24705    149       5     128    C3    P                                    40  25238    98        5     13     C3    P                                    41  23209    71        5     10     C3    P                                    42  53416    NEG       14    81     C3    P                                    ______________________________________                                          *A1 AND A2 refer to asymptomatic, acute (primary) or persistent                generalized lymphadenopathy with CD4 + lymphocyte counts of >500 ul or         200-499/ul, respectively. B2 and B3 refer to symptomatic conditions            different from those in stage A or AIDS, with CD4 + lymphocyte counts of       200-499/ul and <200 ul, respectively. C3 refers to AIDS, with CD4 +            lymphocyte counts of <200/ul (29).                                       

                  TABLE 3                                                          ______________________________________                                         COMPARISON OF SPECIFICITY AND SENSITIVITY OF                                   ULTRASENSITIVE RT ASSAYS USING PREPARED PELLET                                 SAMPLE                                                                                AMP-RT   RT-PCR ASSAY                                                                               PERT ASSAY                                         ______________________________________                                         1. HTLV-I/II AND HIV-1/2 NEGATIVE SERA                                         Negative 12/14      10/14        2/14                                                   85.7%      71.4%       14.2%                                          Positive  2/14       4/14       12/14                                                   14.2%      28.5%       85.7%                                          2. HIV-1 POSITIVE SERUM                                                        Negative  0/14       5/14        3/13                                                     0%       35.7%         23%                                          Positive 14/14       9/14       10/13                                                    100%      64.3%       76.9%                                          ______________________________________                                    

                  TABLE 4                                                          ______________________________________                                         COMPARISON OF SPECIFICITY AND SENSITIVITY OF                                   ULTRASENSITIVE RT ASSAYS USING DIRECT                                          2 μl SAMPLE                                                                        AMP-RT   RT-PCR ASSAY                                                                               PERT ASSAY                                         ______________________________________                                         1. HTLV-I/II AND HIV-1/2 NEGATIVE SERA                                         Negative 14/14       0/14       0/7                                                     100%        0%          0%                                            Positive  0/14      14/14       7/7                                                     100%       100%        100%                                           2. HIV-1 POSITIVE SERUM                                                        Negative  0/14      1/7         2/7                                                      0%         14%         29%                                           Positive 14/14      6/7         5/7                                                     100%        86%         71%                                           ______________________________________                                    

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    __________________________________________________________________________     SEQUENCE LISTING                                                               (1) GENERAL INFORMATION:                                                       (iii) NUMBER OF SEQUENCES: 11                                                  (2) INFORMATION FOR SEQ ID NO:1:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 20 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: DNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:1:                                        CATTAGCCATTTCAACCCAT20                                                         (2) INFORMATION FOR SEQ ID NO:2:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 24 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: DNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:2:                                        GTTCATGACAGGCCGATACAGAGG24                                                     (2) INFORMATION FOR SEQ ID NO:3:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 25 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: DNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:3:                                        TGCTCTCACCTTATCAAAATCCAAT25                                                    (2) INFORMATION FOR SEQ ID NO:4:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 374 base pairs                                                     (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: RNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:4:                                        CAUUAGCCAUUUCAACCCAUGCGUUUGAGGAGAAGCGCUUUCUGAUAACCGGUGGUCUCC60                 CAUCAGGUUGUGCAGCGACCUCAAUGCUAAACACUAUAAUGAAUAAUAUAAUAAUUAGGG120                CGGGUUUGUAUCUCACGUAUAAAAAUUUUGAAUUUGAUGAUGUGAAGGUGUUGUCGUACG180                GAGAUGAUCUCCUUGUGGCCACAAAUUACCAAUUGGAUUUUGAUAAGGUGAGAGCAAGCC240                UCGCAAAGACAGGAUAUAAGAUAACUCCCGCUAACACAACUUCUACCUUUCCUCUUAAUU300                CGACGCUUGAAGACGUUGUCUUCUUAAAAAGAAAGUUUAAGAAAGAGGGCCCUCUGUAUC360                GGCCUGUCAUGAAC374                                                              (2) INFORMATION FOR SEQ ID NO:5:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 22 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: DNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:5:                                        GGTACCTAATACGACTCACTAT22                                                       (2) INFORMATION FOR SEQ ID NO:6:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 49 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: DNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:6:                                        GGTACCTAATACGACTCACTATAGGGAGACATTAGCCATTTCAACCCAT49                            (2) INFORMATION FOR SEQ ID NO:7:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 28 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: DNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:7:                                        ATAATCCACCTATCCCAGTAGGAGAAAT28                                                 (2) INFORMATION FOR SEQ ID NO:8:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 28 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: DNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:8:                                        TTTGGTCCTTGTCTTATGTCCAGAATGC28                                                 (2) INFORMATION FOR SEQ ID NO:9:                                               (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 41 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: DNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:9:                                        ATCCTGGGATTAAATAAAATAGTAAGAATGTATAGCCCTAC41                                    (2) INFORMATION FOR SEQ ID NO:10:                                              (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 24 base pairs                                                      (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: RNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:10:                                       CTCCCATCAGGTTGTGCAGCGACC24                                                     (2) INFORMATION FOR SEQ ID NO:11:                                              (i) SEQUENCE CHARACTERISTICS:                                                  (A) LENGTH: 318 base pairs                                                     (B) TYPE: nucleic acid                                                         (C) STRANDEDNESS: single                                                       (D) TOPOLOGY: linear                                                           (ii) MOLECULE TYPE: RNA (genomic)                                              (xi) SEQUENCE DESCRIPTION: SEQ ID NO:11:                                       CUCCCAUCAGGUUGUGCAGCGACCUCAAUGCUAAACACUAUAAUGAAUAAUAUAAUAAUU60                 AGGGCGGGUUUGUAUCUCACGUAUAAAAAUUUUGAAUUUGAUGAUGUGAAGGUGUUGUCG120                UACGGAGAUGAUCUCCUUGUGGCCACAAAUUACCAAUUGGAUUUUGAUAAGGUGAGAGCA180                AGCCUCGCAAAGACAGGAUAUAAGAUAACUCCCGCUAACACAACUUCUACCUUUCCUCUU240                AAUUCGACGCUUGAAGACGUUGUCUUCUUAAAAAGAAAGUUUAAGAAAGAGGGCCCUCUG300                UAUCGGCCUGUCAUGAAC318                                                          __________________________________________________________________________

31. Myers G, Korber B, Wain-Hobson S, Smith R F Pavlakis G N: "A comparison and Analysis of Nucleic Acid and Amino Acid Sequences." Human Retroviruses and AIDS, 1995. Los Alamos: Los Alamos National Laboratory; 1995.

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What is claimed is:
 1. A method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject comprising the steps of:a) contacting a biological sample from the subject with a ribonucleotide that is a region of the encephalomyocarditis virus genome as an RNA template, a Group M reverse transcriptase inhibiting amount of nevirapine and a oligonucleotide that is a complementary DNA primer under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase in the sample is not inhibited by the nevirapine; b) amplifying the synthesized DNA; and c) detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample.
 2. A method for differentiating between infection by human immunodeficiency virus-1 Group M and Group O in a human immunodeficiency virus-1 infected subject comprising the steps of:a) contacting a biological sample from the subject with a ribonucleotide of SEQ ID NO:4, an oligonucleotide of SEQ ID NO:2 and a Group M reverse transcriptase inhibiting amount of nevirapine under conditions whereby the oligonucleotide and the ribonucleotide will anneal and a DNA strand will be synthesized as an extension from the oligonucleotide if reverse transcriptase in the sample is not inhibited by the nevirapine; b) amplifying the synthesized DNA by the polymerase chain reaction whereby the conditions of the amplification comprise about 35 cycles of heating the synthesized DNA and a primer pair consisting of the oligonucleotide of SEQ ID NO:10 and the oligonucleotide of SEQ ID NO:2 to about 95° C. for one minute, about 55° C. for one minute and about 72° C. for one minute; and detecting the amplification of the synthesized DNA, the amplification of the synthesized DNA indicating the presence of human immunodeficiency virus-1 Group O in the sample. 